理性情绪行为疗法合并生物反馈疗法对医学生社交焦虑的干预效果

目的 探讨理性情绪行为疗法合并生物反馈疗法对医学生社交焦虑的干预效果.方法 58名社交焦虑的医学生,采用随机数字法分成4组,即对照组、行为组、反馈组、综合组.其中对照组未干预,行为组采用理性情绪行为疗法、反馈组采用肌电生物反馈、综合组采用理性情绪行为疗法与肌电生物反馈相结合的方法 分别进行干预,于干预前后分别对各组学生社交焦虑水平进行评估.结果 干预后行为组、反馈组和综合组社交回避及苦恼问卷(SAD)总分[(11.33±5.43)分、(10.75±3.57)分、(7.50±3.42)分]和因子分分别低于对照组[SAD总分(18.08±3.82)分].差异具有显著性(F=13.81,7.80,10.22,P＜0.01).干预后综合组SAD总分下降最为明显,与行为组和反馈组相比差异有显著性(F=10.74,P＜0.01).综合组和行为组下降的社交回避因子分高于反馈组(F=7.46,P=0.01).综合组和反馈组下降的社交苦恼因子分高于行为组(F=15.49,P＜0.01).结论 3种干预方法 对于降低社交焦虑水平均有一定疗效;理性情绪行为疗法合并生物反馈疗法的效果最为显著.     

肌电生物反馈对躯体形式障碍的心理与生理指标的影响

目的:探讨肌电生物反馈对躯体形式障碍患者的生理和心理指标的影响。方法:将160例患者随机分为2组,在药物治疗的基础上,1组加生物反馈治疗,1组加模拟生物反馈治疗,治疗每天1次,治疗4周。采用症状自评量表(SCL-90)评定疗效,每次生物反馈治疗前后测额肌电值、心率、血压,以观察患者生理指标的变化。结果:(1)SCL-90评分,2组比较治疗4周末各因子分均较治疗前有显著下降(P<0.05);(2)额肌电值:入组时2组患者无显著性差异(P<0.05),治疗后2组患者肌电值差异具有统计学差异(P<0.01)。结论:肌电生物反馈治疗躯体形式障碍起效快,可迅速缓解焦虑症状。     

电子生物反馈联合心理护理对老年脑梗死后抑郁患者的临床作用研究

目的:探讨电子生物反馈疗法联合心理干预对老年脑梗死后抑郁患者生理、心理功能的影响.方法:随机将老年脑梗死后抑郁患者分为干预组和对照组,每组各49例,均给予脑梗死常规治疗、抗抑郁药物治疗、康复治疗等以及脑梗死的常规护理,干预组同时实施以心理干预和电子生物反馈为主的综合干预措施;采用汉密顿抑郁量表(HAMD)和神经功能缺陷评分表(NDS)分别对两组患者治疗前及治疗8周后进行评定.结果:干预组总有效率为89.8%,对照组总有效率为73.5%.两组疗效比较差异有统计学意义(P＜0.05).干预8周后,干预组HAMD和NDS评分均低于对照组(P＜0.01).结论:电子生物反馈和心理干预能显着改善老年脑梗死患者的抑郁状态和神经功能,能有效促进患者生理和心理功能的全面康复.     

失眠患者心理干预后的脑电地形图特点分析

目的 探讨经心理干预治疗后的亚健康状态下的失眠患者的脑电地形图特点,以期获得诊断学上的依据.方法 将520例失眠患者随机分为心理干预组与对照组各260例,均给予常规药物治疗,心理干预组配合健康教育、心理疏导等心理干预措施;并随机选取260例健康人群作为正常组.均进行脑电地形图的检查分析.结果 心理干预组与对照组的脑电地形图治疗前差异无统计学意义(P＞0.05),治疗后比较差异有统计学意义(P＜0.05).结论 系统的心理干预治疗对失眠者的脑电地形图有显著改善,可提高失眠者的生活质量.     

针刺并肌电生物反馈疗法治疗脑卒中后偏瘫的疗效观察

目的:观察针刺联合肌电生物反馈疗法治疗脑卒中后偏瘫的临床疗效.方法:将80例脑卒中偏瘫患者随机分为治疗组(n=46)和对照组(n=34),两组均接受神经内科常规治疗.治疗组采用针刺联合肌电生物反馈疗法治疗.治疗6周,于治疗前和治疗后6周进行比较.结果:两组经治疗后,治疗组总有效率为91.3％,对照组总有效率为73.5％,两组总有效率比较有显著性差异(P＜0.05),治疗组患者偏瘫肢体的运动功能恢复情况明显优于对照组.结论:采用不同的针法可以诱发肌张力或缓解肌张力,激活人体的运动和感觉功能;肌电生物反馈疗法可以提高偏瘫肌肉的紧张度,使瘫痪肌肉恢复机能.针灸技术与现代肌电生物反馈技术相结合治疗脑卒中后偏瘫具有明显优势.     

肌电生物反馈治疗对脑卒中恢复期老年患者腕关节功能的影响

目的 探讨肌电生物反馈对脑卒中后老年患者腕关节功能的影响.方法 将2010年10月-2011年10月期间的80例脑卒中后老年患者随机分为治疗组40例和对照组40例,两组行相同药物治疗方案,对照组采用常规康复治疗,治疗组在该基础上加肌电生物反馈技术进行治疗,两组均治疗6个月.分别于治疗前、后采用改良Ashworth量表、Lovett分级评定量表、Brunnstrom分级量表、改良Barthel指数量表评估患者腕关节的功能.结果 经过治疗,两组的上述各项评估结果与治疗前比较,差异有统计学意义（P＜0.05）;但治疗组患者改良Ashworth量表、Lovett分级评定量表、Brunnstrom分期量表以及改良Barthel指数的评估结果均优于对照组（P＜0.05）.结论 常规康复结合肌电生物反馈治疗脑卒中后老年患者,有助于改善腕关节的功能,提高患者生活质量.     

肌电生物反馈放松训练对LBP伴疼痛灾难化患者的康复效果

目的：：观察肌电生物反馈放松训练对下背痛伴疼痛灾难化患者康复治疗效果的影响。方法：50例下背痛伴疼痛灾难化患者随机分为实验组(23例)和对照组(27例),对照组患者仅给予常规康复治疗和常规心理干预治疗,在对照组的基础上,实验组患者还给予肌电生物反馈放松训练。分别于治疗前、治疗14d后采用疼痛灾难化问卷（PCS）、疼痛视觉模拟评分量表(VAS)和OSWESTRY（ODI）腰痛问卷评价两组患者的治疗效果。结果：两组患者治疗前PCS评分、VAS评分、ODI评分比较,差异无统计学意义(P＞0.05)。治疗后两组患者的PCS评分、VAS评分、ODI评分均明显低于治疗前(P＜0.05);并且,实验组患者治疗后的PCS评分、VAS评分、ODI评分均明显低于对照组治疗后(P＜0.05)。结论：对于下背痛伴疼痛灾难化的患者,在传统康复治疗、心理干预的基础上,实施肌电生物反馈放松训练能明显改善治疗效果,有必要进一步研究下背痛与心理因素的临床相关性以及心理干预的方法,使下背痛的治疗更加系统化。     

穴位按摩结合情志疗法对高校学生心理亚健康的干预

目的 探讨穴位按摩结合情志疗法对高校学生心理亚健康状态的影响.方法 将60例高校心理亚健康学生随机分为实验组与对照组,实验组采用穴位按摩结合情志疗法,对照组采用心理健康教育方法.于干预前后采用焦虑自评量表(SAS)、抑郁自评量表(SDS)对2组学生进行评分,并对其结果进行统计分析.结果 经过4周干预后,2组的SAS,SDS评分均比干预前显著降低,差异有统计意义(P＜0.05),表明2组干预方法均能有效地改善高校心理亚健康群体的焦虑、抑郁状态;干预后2组SAS,SDS评分比较,差异均有统计意义(P＜0.05),表明实验组对学生心理亚健康状态的改善作用显著优于对照组.结论 穴位按摩结合情志疗法可有效干预高校学生心理亚健康状态.     

生物反馈放松训练中脑电α波、肌电及皮电的变化

目的 比较采用脑电、肌电、皮电信号进行生物反馈放松训练和音乐放松过程中脑电(EEG)α波相对功率、肌电(EMG)、皮电(GSR)的变化.方法 对16名健康被试首先进行音乐放松30 min,然后按随机顺序采用脑电、肌电、皮电各进行生物反馈放松训练30 min.试验过程中运用spirit-32生物反馈仪记录脑电α波相对功率、肌电、皮电并分析.结果 脑电α波相对功率上升幅度在脑电[(4.49±2.62)%]、肌电[(4.90±4.59)%]、皮电[(3.70±2.87)%]生物反馈放松训练中比音乐放松[(1.28±0.97)%]时明显(t =4.589,3.087,3.187,P ＜0.05).皮电下降幅度在脑电[(2.52±1.58)豪西门子]、皮电[(1.38±0.47)豪西门子]生物反馈放松训练中比音乐放松[(0.75±0.84)豪西门子]时明显(t =3.954、2.582,P ＜0.05).音乐放松、各种生物反馈放松训练使脑电α波相对功率(肌电、皮电)随时间变化的趋势不同(F =2.083,1.773,3.939),P ＜0.05.结论 生物反馈过程中生理信号的上下波动变化可能由于全或无的反馈方式所导致.     

肌电生物反馈联合神经肌肉电刺激对脑卒中急性期上肢运动功能的影响

目的探讨肌电生物反馈联合神经肌肉电刺激对脑卒中偏瘫早期上肢运动功能障碍患者的影响。方法将脑卒中早期合并上肢运动功能障碍患者60例按随机数字表法分为治疗组和对照组,每组各30例。两组均采用常规药物治疗及康复训练,治疗组在此基础上行肌电生物反馈治疗及神经肌肉电刺激,对照组仅给予神经肌肉电刺激治疗。分别于治疗前、治疗后采用Fugl-Meyer运动功能评定法（FMA）评估患者上肢运动功能。结果治疗后,两组患者FMA评分与治疗前相比均有明显提高,差异有统计学意义（P＜0.05）,且治疗组提高更为显著（P＜0.05）。结论肌电生物反馈联合神经肌肉电刺激可有效改善脑卒中患者上肢运动功能。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…